Minimally Invasive Surgery in the Management of Anorectal Malformations

Cairo, Sarah B.; Rothstein, David H.; Harmon, Carroll M.

doi:10.1016/j.clp.2017.08.007

Cited by 15 publications

(17 citation statements)

References 55 publications

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“…The surgical treatment strategy of ARMs, have been a topic of intense focus and debate over the past decades in the field of pediatric surgery, especially in neonates with high-and intermediate-type with ARMs and the intermediate type of male ARMs (with urethralbulbar fistula/no fistula) were recommended to perform one-stage operation instead of a colostomy when the baby has no severe associated defects. [4][5][6]8 In addition, the pediatric surgical community recommends LAARP for the ARMs with bladder-neck/urethral-prostatic fistula and PSARP for the ARMs with urethral-bulbar fistula/no fistula in order to well functional results. 4,6,20 Laparoscopy is a less invasive method for ARMs with bladder-neck/urethral-prostatic fistula which have previously required a laparotomy.…”

Section: Discussionmentioning

confidence: 99%

Prediction of anorectal malformations with bladder‐neck/urethral‐prostatic fistula using classification and regression tree analysis

Yuan

Feng

Huang

et al. 2022

J of Clinical Ultrasound

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Background The anorectal malformations (ARMs) with bladder‐neck/urethral‐prostatic fistula in males are the most complex groups in ARMs. It is essential to diagnose them effectively before the primary operation for both surgical modalities and future functional prognosis can be quite different from other types. Our study aimed to develop a classification and regression tree (CART) model for the prediction of ARMs with bladder‐neck/urethral‐prostatic fistula. Methods A total of 132 newborns with ARMs were included retrospectively and randomly assigned to the training sample and test sample in a 3:1 ratio. The pouch‐perineum distance of ultrasound (PPDU), the pouch‐perineum distance of invertogram (PPDI), and the rectum gas above the coccyx (RGAC) on the invertogram were hypothesized can serve as individual predictors. The CART analysis was used to determine the best combination of candidate predictors. The model's performance was assessed by the area under the receiver operating characteristic curve (AUC) and validated in the test sample. Results All three individual predictors were included in the CART model to predict the ARMs with bladder‐neck/urethral‐prostatic fistula in the derivation cohort with the following test characteristics (95% CI): sensitivity 75.6% (60.1 to 86.6); specificity 88.9% (76.7 to 95.4); AUC 0.909 (0.854 to 0.965). The model's predicted accuracy was validated in the test cohort (AUC = 0.883). In all 132 subjects, the AUC of the tree model was significantly superior to that of the best individual index: PPDU (0.901 vs. 0.819; p = 0.005). Conclusions A predictive model that consists of PPDU, PPDI, and RGAC may be useful in predicting ARMs with bladder‐neck/urethral‐prostatic fistula.

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Section: Discussionmentioning

confidence: 99%

Prediction of anorectal malformations with bladder‐neck/urethral‐prostatic fistula using classification and regression tree analysis

Yuan

Feng

Huang

et al. 2022

J of Clinical Ultrasound

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“…A partir dos dados coletados, foi observado discreta predominância da incidência de AAR no sexo masculino, 59,2%, sendo compatível com parte da literatura. 2,12 Dentre pacientes do sexo masculino, a AAR com fístula perineal -correspondente a 36,1%, seguida da sem fístula, com 31,1% e da uretral com 21,3% -foi a mais encontrada neste estudo. Cassina et al 12 Já no sexo feminino, houve equivalência entre os dados encontrados, sendo a AAR com fístula vestibular 59,5%, seguida pela fístula perineal, com 21,4%, as mais comuns.…”

Section: Discussionunclassified

“…Cassina et al 12 Já no sexo feminino, houve equivalência entre os dados encontrados, sendo a AAR com fístula vestibular 59,5%, seguida pela fístula perineal, com 21,4%, as mais comuns. 2,12 A prematuridade foi um fator relevante para mortalidade, visto que 50% dos pacientes prematuros evoluíram a óbito (n=20), enquanto não prematuros 20,3% dos (n=64) apresentaram mesmo desfecho (p = 0,019). (Tabela 1) Além disso, constatou-se que a ocorrência de sepse foi de 17,5% entre todos os pacientes estudados, submetidos a qualquer dos tipos de abordagem cirúrgica, ocorrendo óbito em 68,4% (p = 0,001 (Tabela 1).…”

Section: Discussionunclassified

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Perfil epidemiológico e avaliação das complicações a curto prazo em pacientes com anomalias anorretais tratados no instituto de medicina integral Prof. Fernando Figueira (IMIP) – estudo descritivo/ Epidemiological profile and evaluation of short-term complications in patients with anorectal malformations treated at the institute of integral medicine Prof. Fernando Figueira (IMIP) - descriptive study

Sá¹,

D’Azevedo²,

Gallindo³

2021

Braz. J. Hea. Rev.

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Descrever o perfil epidemiológico do paciente com anomalias anorretais (AAR) atendido no Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) em Pernambuco e avaliar as complicações a curto prazo mais frequentes no pós-operatório no serviço. MÉTODOS: estudo descritivo, retrospectivo, longitudinal realizado a partir da análise dos prontuários de 108 pacientes nascidos entre janeiro de 2014 e dezembro de 2018 com diagnóstico de AAR acompanhados e tratados no departamento de Cirurgia Pediátrica do IMIP (hospital referência em malformações congênitas no estado de Pernambuco). A pesquisa foi realizada no período de agosto de 2019 a setembro de 2020. Foram estudados aspectos relacionados ao pré-natal, ao puerpério imediato e ao período pós-natal, observando as características das AAR e do tratamento da patologia. Os dados foram coletados em prontuários desses pacientes e analisados a partir dos

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“…Other systems affected with associated anomalies are cardiovascular, gastrointestinal tract (GIT), vertebra, and nervous system. 4,5 Unlike normal newborns, the frequency of CHDs is greater in patients with malformations of GIT. In general population the incidence of CHD is <1%, but the significant association between major GI malformations and CHDs has been historically emphasized.…”

Section: Introductionmentioning

confidence: 98%

Frequency of congenital cardiac anomalies in patients with anorectal malformations.

Ali

Uzair

Rehman

et al. 2020

TPMJ

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Objectives: To determine the frequency of congenital cardiac anomalies in patients with anorectal malformations. Study Design: Retrospective study. Setting: Department of Pediatric Surgery, Khyber Teaching Hospital, Peshawar. Period: Jan 2018 to June 2018. Material & Methods: All patients from 0 to 30 days of life both males and females (Inclusion criteria) with diagnosed anorectal malformation on clinical and radiological assessment, underwent cardiovascular work up to identify any cardiovascular disease. Patients with intersex disorders and those operated elsewhere were excluded. Mean and standard deviation were calculated for age. Frequency and percentage were calculated for gender, type of anorectal malformation, genital ambiguity, previous surgical intervention and congenital cardiac anomalies. Data was stratified for age, gender, lesion level, genital ambiguity and previous surgery to see the effect modification. Results: Out of 90 patients with anorectal malformation, there were 49 (54%) males and 41 (46%) females (M: F;1:1.19). with mean age of 7.65 ± 2.43 days. There were 39 (43.34%) patients with low anorectal malformation and 51 (56.67%) patients with high anorectal malformation. Genital ambiguity and previous surgical intervention was present in 8 (8.89%) and 11 (12.23%) patients, respectively. Congenital Cardiac Anomalies were diagnosed in 16 (17.78%) patients with anorectal malformation. Congenital Cardiac Anomalies were mostly seen in age group 1-10 days (21.95%), male children (22.45%) and high anorectal malformation (23. 52%). Conclusion: The frequency of congenital cardiac anomalies in patients with anorectal malformations was found lower than local figures. The majority of congenital cardiac anomalies associated with high anorectal malformation and male gender.

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Minimally Invasive Surgery in the Management of Anorectal Malformations

Cited by 15 publications

References 55 publications

Prediction of anorectal malformations with bladder‐neck/urethral‐prostatic fistula using classification and regression tree analysis

Prediction of anorectal malformations with bladder‐neck/urethral‐prostatic fistula using classification and regression tree analysis

Frequency of congenital cardiac anomalies in patients with anorectal malformations.

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